20060951 Ver 1_401 Application_20060606

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Davidson Soil and Water Conservation District
301 East Center Street -Lexington, NC 27292-4107 -Phone [phone] -Fax [phone]
June 7, 2006
NC Division of Water Quality ~ d~ 6 0 9 5 ~
401 Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
To Whom It May Concern:
Enclosed are seven copies of the Pre-construction Notification Form and a check for the
permit fee in the amount of $200.00 for the Richard Johnston Streambank Stabilization
Project in Davidson County, North Carolina. The United States Department of
Agriculture -Natural Resources Conservation Service, provided the design for this
project. This site was also reviewed for acceptance in the North Carolina Ecosystem
Enhancement Program but was not included in the Program at this time.
Please contact me at 336-242-2075 or at amiller(a~co.davidson.nc.us if I can be of
assistance as you process this request.
Sincerely,
An Miller
District Soil Conservationist
Enclosure:
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Office Use Only: Form Version March OS
~''~ ~0 9 5 1
USACE Action ID No. DWQ No.
fit any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
I. Processing
Check all of the approval(s) requested for this project:
® Section 404 Permit ^ Riparian or Watershed Buffer Rules
^ Section 10 Permit ^ Isolated Wetland Permit from DWQ
® 401 Water Quality Certification ^ Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: NW 33, NW13
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ^ N/A
4. If payment into the North Carolina Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here: ^ N/A
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Ma ~~~ of
Environmental Concern (see the top of page 2 for further details), check her ~V~
II. Applicant Information JUN X 2 2006
1. Owner/A licant Information oENR - wArER Qu,~;~-y
pP WETLANDS AND STORMW.~TER BRANCH
Name: Richard C. Johnston, Jr.
Mailing Address: 1242 Motsin~er Road
Winston-Salem, NC 27107-9765
Telephone Number: 336-906-7554 Fax Number:
E-mail Address:
2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name: Andy Miller
Company Affiliation: Davidson Soil and Water Conservation District
Mailing Address: 301 East Center Street
Lexington NC 27292-4107
Telephone Number: 336-242-2075 Fax Number: 336-242-2982
E-mail Address: amiller(a~co.davidson.nc.us
Updated 11/1/2005
Page 5 of 12

III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps maybe included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: Richard Johnston Streambank Stabilization
2. T.I.P. Project Number or State Project Number (NCDOT Only): N/A
3. Property Identification Number (Tax PIN): 6851-02-69-8049
4. Location
County: Davidson Nearest Town: Wallbur~
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers/names, landmarks, etc.):From Winston-Salem take
NC Hi~hway 109 South to Wallbur~ Turn right (South) onto Motsin~er Rd (SR 1723L_
Follow Motsin~er Rd. approx. 1 mi and turn right ont a private driveway beside an older
white house. Follow driveway to Brushy Fork Creek
5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum): 35° 59' 42" °N 80° 09' 30" °W
6. Property size (acres):
7. Name of nearest receiving body of water: Brushy Fork Creek
8. River Basin: Yadkin
(Note -this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admit/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: Stream banks and channel are severely eroding downstream
of the driveway. The site surrounding the stream is wooded gassed and cropland
Updated 11/1/2005
Page 6 of 12

10. Describe the overall project in detail, including the type of equipment to be used: Install
15 ft. of 5 ft. dia. CMP to existing culvert Fill with select soil around culvert Shape
streambanks to stable slopes Install ~eotextile filter fabric Place rock rip rap Install
erosion control matting. Plant trees and grass Equipment to be used• track hoe pump to de
water, track loader tractor with assorted attachments
1 1. Explain the purpose of the proposed work: To stabilize severel eroding streambanks at a
private driveway crossing.
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.N/A
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts. to
wetlands, open water, and stream channels associated with the project. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should be shown on a delineation map, whether or not impacts are proposed to these systems.
Wetland and stream evaluation and delineation forms should be included as appropriate.
Photographs maybe included at the applicant's discretion. If this proposed impact is strictly for
wetland or stream mitigation, list and describe the impact in Section VIII below. If additional
space is needed for listing or description, please attach a separate sheet.
1. Provide a written description of the proposed impacts: Culvert installation ading_
streambank, i,lacin~ rip-rap establishing_permanent vegetation
Updated 11/1/2005
Page 7 of 12

2. Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For dams,
separately list impacts due to both structure and flooding.
Wetland Impact
Site Number
(indicate on map)
Type of Impact Type of Wetland
(e.g., forested, marsh,
herbaceous, bog, etc.) Located within
100-year
Floodplain
es/no Distance to
Nearest
Stream
(linear feet Area of
Impact
(acres)
N/A

Total Wetland Impact (acres)
3. List the total acreage (estimated) of all existing wetlands on the property:N/A
4. Individually list all intermittent and perennial stream impacts. Be sure to identify temporary
impacts. Stream impacts include, but are not limited to placement of fill or culverts, dam
construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
walls, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed,
plans and profiles showing the linear footprint for both the original and relocated streams
must be included. To calculate acreage, multiply length X width, then divide by 43,560.
Stream Impact
Number
indicate on ma
Stream Name
Type of Impact Perennial or
Intermittent? Average
Stream Width
Before Im act Impact
Length
(linear feet Area of
Impact
(acres
1 Brushy Fork Creek Grading Perennial 16 90 0.2
2 Brushy Fork Creek Fill Perennial 16 15 <0.1
3 Brushy Fork Creek Culvert Perennial 16 15 <0.1
4 Brushy Fork Creek Rip-Rap Perennial 16 80 0.2

c7~%C1
Total Stream Impact (by length and acreage) 0.2
NOTE: fill, culvert, and rip-rap impacts are included with the length and area impacted by the grading.
5. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fill, excavation, dredging, flooding, drainage, bulkheads, etc.
Open Water Impact

Site Number
(indicate on ma
Name of Waterbody
(if applicable)

Type of Impact Type of Waterbody

(lake, pond, estuary, sound, bay,
ocean, etc. Area of

Impact
acres)
N/A

Total Open Water Impact (acres)
Updated 11/1/2005
Page8of12

6. List the cumulative impact to all Waters of the U.S. resulting from the project:
Stream Impact (acres): 0.2
Wetland Impact (acres): N/A
O en Water Irri act (acres): N/A
Total Impact to Waters of the U.S. (acres) 0.2
Total Stream Impact (linear feet): _ ~o ~
7. Isolated Waters
~~
Do any isolated waters exist on the property? ^ Yes ®No
Describe all impacts to isolated waters, and include the type of water (wetland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies to waters that have specifically been determined to be isolated by the USACE.
8. Pond Creation N/A
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ^ uplands ^ stream ^ wetlands
Describe the method of construction (e.g., dam embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Current land use in the vicinity of the pond:
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It maybe useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.This project is intended to
eliminate or reduce existing streambank erosion. After reviewing with USDA-NRCS.
NCDENR Div. of Soil and Water Coservation, and NC EEP staff this approach was considered
to be the most appropriate.
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
Updated 11/1/2005
Page 9 of 12

USAGE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on January 15, 2002, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USAGE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCEEP concurrence shall be placed on hold as incomplete.
An applicant may also choose to review the current guidelines for stream restoration in DWQ's
Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.em•.state.nc. us/ncwetlands/strmgide.html.
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
N/A
2. Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement
Program (NCEEP). Please note it is the applicant's responsibility to contact the NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
that they are will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at http:/11120.enr.state.nc.us/wrp/index.htm. If use of the NCEEP is proposed, please
check the appropriate box on page five and provide the following information:
Amount of stream mitigation requested (linear feet): N/A
Amount of buffer mitigation requested (square feet): N/A
Amount of Riparian wetland mitigation requested (acres): N/A
Amount ofNon-riparian wetland mitigation requested (acres): N/A
Amount of Coastal wetland mitigation requested (acres): N/A
Updated 11/1/2005
Page 10 of 12

IX. Environmental Documentation (required by DWQ)
1. Does the project involve an expenditure of public (federaUstate/local) funds or the use of
public (federaUstate) land? Yes ® No ^
2. If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ^ No
3. If yes, has the document review been finalized by the State Clearinghouse? If so, please
attach a copy of the NEPA or SEPA final approval letter. Yes ^ No ^
X. Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
1. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Neuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify )? Yes ^ No
2. If "yes", identify the square feet and acreage of impact to each zone of the riparian buffers.
If buffer mitigation is required calculate the required amount of mitigation by applying the
buffer multipliers.
* I Impact Required
Zone ~~~ ~rA f o*~ Multiplier r,~;«:,..,«;,.,,
i 3 (2 for Catawba)
2 1.5
Total
* Zone 1 extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additiona120 feet from the edge of Zone 1.
3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration /Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within 15A NCAC 2B .0242 or .0244, or .0260.
Updated 11/1/2005
Page 11 of 12

XI. Stormwater (required by DWQ)
Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
stormwater controls proposed in order to protect surface waters and wetlands downstream from
the property. If percent impervious surface exceeds 20%, please provide calculations
demonstrating total proposed impervious level. All areas are and will be pervious.
XII. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ^ No
Is this anafter-the-fact permit application? Yes ^ No
XIV. Cumulative Impacts (required by DWQ)
Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes ^ No
If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with
the most recent North Carolina Division of Water Quality policy posted on our website at
http://h2o.enr.state.nc.us/ncwetlands. If no, please provide a short narrative description:
This protect is to provide safe ingress and egress to a farm and a single family home No
additional development is planned.
XV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
Applical~gent's Signature ~'
(Agent's signature is valid only if an auth rization letter from the applicants
Updated 11/1/2005
Page 12 of 12

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Conservation Plan Map
Customer(s): R C JOHNSTON
District: DAVIDSON SOIL & WATER CONSERVATION DISTRICT
Date: 3/30/2006
Field Office: LEXINGTON SERVICE CENTER
Agency: USDA_NRCS
Assisted By: Bruce T Wilson

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RICHARD JOHNSTON
CULVERT OUTLET PROTECTION
DAVIDSON COUNTY, NC
SEQUENCE OF CONSTRUCTION
De-water the culvert outlet area with a pump large enough for the task and maintain
as needed during the construction.
2. Grade and shape the culvert outlet area as shown on the drawings. All fill material
needs to be compacted in place using the excavation equipment.
3. Construct a floodplain bench at 3 feet above the normal water level with a top width
that is as wide as practical and still have a 2/1 side slope up to the top edge of the road
fill. In the area just around the culvert outlet there is not room for a bench. This area
will be graded with a 2/1 slope.
4. Excavate and prepare for the placement of the NC DOT Class 2 riprap. The riprap
will be placed on a 6-oz./sq. yd. non-woven geotextile. Place the riprap as shown on
the drawings.
5. Dress and shape all slopes and prepare all exposed areas to be seeded. Seed the area
as specified in the seeding specification.
6. Install the erosion control fabric. (North American Green SC150 or equal)
7. Plant rooted Silky Willow or Silky Dogwood on the floodplain bench. Live stakes of
this willow and dogwood can be used instead of rooted plants provided the live stakes
are 30 inches minimum long and can be installed during February or March when the
live stakes are dormant and the soil material is wet enough for them to be easily
driven 24 to 28 inches into the soil.
8. Water all plants as needed until established.

RICHARD JOHNSTON
CULVERT OUTLET PROTECTION
DAVIDSON COUNTY, NC
BILL OF MATERIALS
225 tons of NC DOT Class 2 riprap
300 square yards of 6 ounce non-woven geotextile
200 square yards of erosion control fabric (North American Green SC150 or equal)
100 rooted Silky Willow or Silky Dogwood trees
150 Silky Willow or Silky Dogwood live stakes
Seeding (see the seeding specifications sheet)
15 feet of 5 foot diameter 12 gauge Corrugated Metal Pipe
7 degree elbow band connector for 5 foot diameter Corrugated Metal Pipe (12 gauge)
Pump and piping to de-water the site (pump should handle a minimum of 300 gallons per
minute and utilize 4 inch diameter lines)
Fill material for slopes and around culvert

SEEDING SPECIFICATIONS
Name: Richard Johnson.
COUNTY: Davidson, NC
A. Site Preparation
Smooth land to fill rills and washes so runoff will not be concentrated and to
provide uniform slopes.
2. Perform all land preparation and seeding on the general contour.
B. Seedbed Preparation
Prepare a seedbed 3 to 5 inches deep or as determined by NRCS or District
personnel on site. Scarify the surface with suitable equipment such as a chain
harrow, grader with chisels attached or with hand tools. Ripping chisels or tools
must be spaced not more than 12" apart.
C. Seeding
1. Use a cyclone seeder, Brillion-type seeder, or other appropriate seeding apparatus
to achieve a'/2 inch seeding depth. Where a cyclone seeder is used, cross seed by
seeding one half of the seed in one direction and the other half at right angles.
When the seed are broadcast, cover them to a'/2 inch depth and cultipack the
entire area immediately following seeding. All operations using a Brillion-type
seeder or cultipacker should be done across the slope.
2. Hydraulic seeding -Mix the fertilizer, seed and wood cellulose fiber mulch with
water and apply the slurry uniformly over the area being treated. The slurry must
be applied within one hour after mixing the seed with the fertilizer.
3. Mulching -Mulch all areas immediately after seeding. Mulch must cover 75% of
the surface area.
D. Temporary Seeding
~. Provide temporary seeding during the late winter and summer months (see list
below). Permanent seeding should be established as soon as possible based on
appropriate seeding dates.
E. Lime, Fertilizer, and Seed
Estimated Area = arees*
Seeding Dates Amount
601bs. of fescue (KY -31) per acre Aug. 15 -Oct 31 = lbs.
(permanent) Feb. 15 -April 15
SO lbs. of rye-grain per acre (temporary) Nov. 1 -Feb. 14 = lbs.
401bs. of browntop millet per acre April 15 -Aug 15
(temporary) lbs.
2501bs. of 46% phosphate per acre = lbs.
10001bs. of 10-10-10 fertilizer per acre = tons.
40001bs. of lime per acre = tons.
125 bales of straw per acre = bales
* Measure area(s) to be seeded prior to seeding and adjust acreage and quantities of

PLANNED RCJADSIDE
EDGE FILL
SLEPE AS%STEEP AS 1~z5/1
SC150 NORTH AMERICAN GRFE~N -- -.---,.
--
EROSION CONTREL F~RIC %~
or ,EQUAL
CROSSECTIEN VIEW ALIGNMENT
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CORRUGATED STEEL PIPE
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CANNED ADDITIONAL 15' OF 5' dia.
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,BEDDING FOR NEW PIPE NON WOVEN GEOTEXTILE PLANNED STREAM BOTTOM
0 10 20 30 40 5 60 70 80 90 100 110

C/L PIPE
EXISTING GROUND
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90 EXCAVATE
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EROSION CONTROL
FABRIC
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PROFILE
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INVERT ELEV. 80.6
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